CMS Formulary

Displaying 57451-57460 of 1611142 results.
ID: 57451
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57452
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57453
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57454
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57455
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57456
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57457
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57458
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57459
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57460
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0